NPI | 1629631767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: MD H0097015) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD H0097015) |
Enumeration Date | 2019-04-15 |
Last Update Date | 2023-08-29 |